Annals On Call - Against Medical Advice: We Need Better Terminology
Authors: Robert M. Centor, Robert A. Kleinman
Journal: Annals of Internal Medicine (2023)

Web ExclusivesMarch 2023Annals On Call - Against Medical Advice: We Need Better TerminologyFREERobert M. Centor, MD and Robert A. Kleinman, MDRobert M. Centor, MDHuntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)Search for more papers by this author and Robert A. Kleinman, MDCentre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (R.A.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/A22-0005 CME/MOC SectionsAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this episode of Annals On Call, Dr. Centor discusses why the discharge description “against medical advice” should not be used with Dr. Robert Kleinman.Annals articles discussed include...Retiring the “Against Medical Advice” Discharge: https://www.acpjournals.org/doi/10.7326/M22-2964About Annals On CallAnnals On Call focuses on a clinically influential article published in Annals of Internal Medicine. Dr. Robert Centor shares his own perspective on the material and interviews topic area experts to discuss, debate, and share diverse insights about patient care and health care delivery.For more information on Annals On Call and for more episodes, visit go.annals.org/OnCall. Comments0 CommentsSign In to Submit A Comment Rob KlienmannACP Fellow3 April 2023 Signing against medical advice I agree with the authors that signing/leaving against medical advice doesn't seem medical or in line with the relation between patients and clinicians. Long ago I had been trying to use "discharged on request." This terminology means that the clinician has respected the patient's preference and responded to the patient's request. The word "request" also implies respect from the patient's side towards the clinician. I don't agree with the phrase, "patient directed discharge," because "discharge" is mainly a clinician's decision not the patient's decision. Dr Robert M CentorProfessor-Emeritus4 April 2023 Author Response to Kleinmann I certainly agree with this comment. Spot on. Author, Article, and Disclosure InformationAuthors: Robert M. Centor, MD; Robert A. Kleinman, MDAffiliations: Huntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (R.A.K.)Disclosures: All relevant financial relationships have been mitigated. Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=A22-0005.Editors' Disclosures: The editors have no relevant financial relationships to disclose. Individual forms may be viewed at www.annals.org/editorsdisclosures.This article was published at Annals.org on 7 March 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRetiring the “Against Medical Advice” Discharge Robert A. Kleinman , Thomas D. Brothers , and Nathaniel P. Morris Metrics March 2023Volume 176, Issue 3 ePublished: 7 March 2023 Issue Published: March 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.Loading ...